青海省成人大骨节病患者掌指骨X线征象分析  

X-ray characteristics of metacarpus and phalange in adult patients with Kaschin-Beck disease in Qinghai Province

作　　者：赵志军[1] 李强[2] 刘玉芳[2] 李生梅[2] 杨佩珍[2] 孟献亚[2] 徐小青[2] 余慧珍[2] 孙丽艳[1] 朱雷[1] 王丽华[1] 蒲光兰[2] 

机构地区：[1]哈尔滨医科大学中国疾病预防控制中心地方病控制中心地氟病防治研究所,哈尔滨150081 [2]青海省地方病预防控制所,西宁811602

出　　处：《中华地方病学杂志》2016年第1期54-57,共4页Chinese Journal of Endemiology

摘　　要：目的分析青海省成人大骨节病患者右手掌指骨X线征象，了解成人大骨节病的好发部位。方法按照《大骨节病诊断》（WS／T207-2010）对青海省111例临床诊断为成人大骨节病的患者进行右手掌指骨X线拍片，选择关节间隙狭窄、关节增粗、关节软骨面下硬化、骨赘、囊样变、毛糙不整和凹陷缺损作为描述性指标，采用SPSS17．0进行统计分析。结果共检查111例成人大骨节病患者右手掌指骨X线，检出异常103例，异常率为92．79％。Ⅱ～Ⅳ指骨为好发部位，其中Ⅱ指骨近节、中节发生影像学改变95例，占92．23％（95／103）；Ⅲ指骨近节、中节发生影像学改变102例，占99．03％（102／103）；Ⅳ指骨近节、中节发生影像学改变102例，占99．03％（102／103）。Ⅱ-Ⅳ指骨近节、中节影像学改变率比较，差异有统计学意义（Ⅱ-Ⅳ近节指骨影像学改变为关节增粗212例、凹陷缺损7例、毛糙不整134例、骨赘47例、囊样变15例、关节间隙狭窄115例：Ⅱ-Ⅳ中节指骨影像学改变为关节增粗77例、凹陷缺损37例、毛糙不整137例、骨赘26例、囊样变19例、关节间隙狭窄126例，χ^2=79．33，P〈0．05）。结论手部Ⅱ-Ⅳ指骨是成人大骨节病患者的好发部位。Objective To analyze the radiographic characteristics of right hand X-ray film of adult patients with Kaschin-Beck disease （KBD） in Qinghai Province, to understand the most affected locations in adult KBD. Methods According to the criteria of KBD diagnose （WS/T 207-2010）, 111 cases of patients were taken X-ray films of right hands. Joint space narrow, joint deformity, subehondral sclerosis, osteophyte, coarse and irregularity of joint, marginal retraction sign and capsule changes were chosen as the descriptive indexes, and these indexes were analyzed with SPSS 17.0. Results A total of 111 cases adult patients with KBD were examined right hand by X-ray, abnormality on X-ray film were 103 cases, the abnormal rate was 92.79%. The most affected fingers were Ⅱ - Ⅳ phalanx bones, Ⅱ phalanx bones accounted for about 92.23% （95/103）, Ⅲ phalanx bones accounted for about 99.03% （102/103）, and Ⅳ phalanx bones accounted for about 99.03% （102/103）. There was significant difference of the abnotmality between the proximal phalanx and the middle phalanx among the Ⅱ - Ⅳ phalanx bones（χ^2 = 79.33, P 〈 0.05）. Abnormal numbers of joint deformity, marginal retraction sign, coarse and irregularity of joint, osteophyte, capsule changes and joint space narrow in the proximal phalanx were 212, 7, 134, 47, 15 and 115 in Ⅱ - Ⅳ proximal phalanx, respectively; while the abnormal numbers of joint deformity, marginal retraction sign, coarse and irregularity of joint, osteophyte, capsule changes and joint space narrow in the middle phalanx were 77, 37, 137, 26, 19 and 126 in Ⅱ - Ⅳ middle phalanx, respectively. Conclusion The Ⅱ - Ⅳ phalanx bones of right hand are the most affected locations in adult KBD.

关 键 词：大骨节病 掌骨 指骨 X线 

分 类 号：R684.1[医药卫生—骨科学]